Key Issue: Health

Key Issue: Health

Trusted health information is a vital service in its own right

Internews has a unique role in supporting information that is vital to the effective delivery of global health services. For 35 years, we have worked to ensure access to trusted information people need to make the best decisions for themselves, their families and their communities.

Achieving global health goals requires high-quality, culturally-sensitive and contextually-appropriate health services and information that reach all people regardless of gender, ethnicity or social context.

To make informed choices, people must have access to timely, accurate information in languages they understand and from sources they trust.

Internews works with our partners around the globe to:

Engage and inform;

Build local capacity to hold to account those who provide health products and services; and

Facilitate two-way conversations that shape and change norms.

Health information, governance, and product and service delivery programs can all be improved significantly when effective, local information in languages people can understand is a part of the solution.

"The importance of communication is a no-brainer. Medical hubris has led us to believe that drugs can solve health problems. But people need to know about the drugs." — PETER PIOT, London School of Hygiene

Related Stories - Health

Every two years, in July, when thousands of delegates – top scientists, global health leaders, celebrities, advocates, activists, affected people and health budget writers – gather at the international AIDS conference, editors fix their eye on the big breakthrough story: Is there a cure? Do we have a vaccine yet? What will it take to end HIV?
The answers? No. No. Lots.
In other words, no clear headline story emerged from the conference, which was held in Amsterdam this year. And therein lies the story. In a tweet or two, this is where science and society are at with the HIV response:
There is a #HIVprevention crisis. The success in saving lives has not been matched with equal success in reducing new #HIVinfections.
Miles To Go: a new @UNAIDS global report warns that progress in ending the #AIDS epidemic is slowing and time is running out to reach the 2020 #HIV targets.
#AIDS2018 — The Story is Vulnerable: The AIDS response is largely missing the boat on combination prevention, with sloppy definitions, inadequate funding and poor adaptation of evidence.
“The world is badly off target to meet UNAIDS goals of ending AIDS by 2030, but some countries are making impressive progress.”
As before, hundreds of journalists attended the conference – their stories a reflection of the inch-by-inch progress in science, and of the fears that complacency will cancel out gains. Stories about stigma and how not to be seized by it. Policy stories that push for the rollout of Pre-Exposure Prophylaxis (PrEP). Global goals and country-specific strategies to reach the targets to attain what is termed “epidemic control.”
The profound promise of new prevention technologies being tested for efficacy in several countries in Sub-Saharan Africa: anti-retroviral (ARV)-based vaginal rings, long-acting injectable PrEP, the infusion of those super effective antibodies produced by some HIV infected people into the bloodstream of HIV negative people to test if it can help them ward off infection. And of course, the quest for an HIV vaccine.
Misleading Stories
Coming out of the AIDS conference in Amsterdam were, predictably, a mix of HIV vaccine stories. Just before the conference, a story with this headline was published: “Huge Breakthrough in Global Fight against HIV with a Promising New Vaccine.” The story was not accurate. But unpacking where this reporter – and others who wrote similar stories – got it wrong gets us to heart of why vaccine science is a knotty area to report on.
The story had missed the nuance of data published in The Lancet earlier in July. It gets very technical, but, in a nutshell, the misunderstanding stems from the timing of the release of a subset of data from the APPROACH safety and efficacy vaccine study, which is relevant and meaningful to those who follow vaccine science closely, but not necessarily to those who don’t. Earlier results from this study had already been sufficiently impressive for the selected candidate vaccine to be taken forward into a large-scale human efficiency trial dubbed Imbokodo. The new data highlights findings from a side study of APPROACH, which shows that the candidate vaccine produced an immune response in rhesus monkeys similar to the response in humans. In a Comment piece, The Lancet describes the findings as a “New step towards an HIV vaccine” (not a “huge breakthrough” and it is not a “new vaccine”). The Independent more soberly reported: “HIV Vaccine Human Trials Leave Scientists 'Cautiously Pleased.'”
I am lucky to be working with journalists who want to tell stories about this science – and not just when there is a major AIDS conference – through a project called CASPR, the Coalition to Accelerate and Support Prevention Research. CASPR supports journalist organizations hosting media science cafés in Uganda, Zambia and Kenya.
In all three countries, health journalists get the question, “Why is there no HIV vaccine yet?” The reason is because it is complicated. Their stories explain that vaccines teach the body’s immune system how to mount a response against the agent that has infected it. However, HIV attacks the very immune system that has to mount a response. Plus, HIV makes many copies of itself and mutates so that the immune system cannot recognize it. But scientists – and the thousands of volunteers in clinical trials – persist with this quest, because an HIV vaccine would be a game changer. Somewhere between the collective eagerness for a vaccine and the complexity of the enquiry, media stories can be overly upbeat or just wrong.
Research Translation
The purpose of CASPR is to create an enabling environment for HIV prevention science. This means – among other things – that the science must be understood.
“If they understand it well, they’ll even get excited about it!” Ntando Yola told East and Southern African health journalists who had gathered in Botswana in April to learn more about translating the science behind a number of HIV prevention trials being held in their countries.
Ntando is a community liaison and education officer with the Desmond Tutu HIV Foundation in Cape Town. His job is to ensure that communities living in areas where trials take place are given the space to participate in decisions, that they feel ownership of the research and have an interest in its success. Right man for the job! He had the journalists spellbound with tips to ensure their audiences grasp the concepts in prevention science.
In his work, Ntando is asked about HIV prevention options all the time. There have been breakthroughs with antiretrovirals used as prevention and success stories with voluntary medical male circumcision (VMMC). Ntando says the prevention option we’ve heard scientists talk about for decades now demands a way with words that keeps the dream alive, yet doesn’t create false or fast hopes.
“The HIV vaccine is that special child who gets all the attention. Everyone creates a big fuss about the child, but he does not seem to have much to show for the fuss,” says Ntando. “We always hear about his potential and that we need to wait a little before he reaches his full potential.”
Finding a Way to Communicate the Complexity
Steve Wakefield, External Relations Director for the HIV Vaccine Trials Network (HVTN), is a health care advocate with over 30 years of involvement in projects that increase community participation, particularly for African Americans. He has been talking about the potential of an HIV vaccine for as almost as long as we’ve known about the virus.
In 1998 he was on one of his many fact-finding and support missions in South Africa, and was asked by another stalwart of community engagement, Janet Fröhlich, to join her at a vaccine preparedness event in a town called Hlabisa, in KwaZulu-Natal, often described as the epicenter of HIV infection in South Africa. Janet was working for South Africa’s Medical Research Council (MRC) at the time, and her drive was to ensure that people have sufficient information about what an HIV vaccine could achieve. In time, South Africa’s research institutions would want to enroll volunteers into vaccine trials. Wakefield and Janet recall how they consulted with community leaders about finding metaphors for an HIV vaccine that would be clear, but not condescending to people who were already desperate to see the end of AIDS.
The child immunization effort in the public health system was very successful in rural South Africa, so the early vaccine preparedness team linked an HIV vaccine to concepts like injections to prevent smallpox and measles. Immunization, “ukugoma mntwana kuvimbela isifo” in isiZulu, translates as “protect the child to prevent illness” – exactly what an HIV vaccine would do. Cattle farmers also could relate to the idea, as only vaccinated cattle were healthy.
Moving from the farmyard to the kitchen, Wakefield also spoke about how making a vaccine is really the same as baking a cake. “The only way to get to an edible cake is to try and try again – first the human body has to tolerate it, but it is only really a cake if it is sweet and has good texture.” Wakefield says if a journalist has a gut feeling that such comparisons might sound too simplistic, they should listen to their inner voice. But that inner voice should also warn them if the language from scientists is too complex. Finding something that is accessible, yet respects and reflects the complexity is what successful research translation is about.
Wakefield says journalists need to find a balance between writing that is too complex or too condescending. Finding something that is accessible, yet respects and reflects the complexity is what successful research translation is about.
Media Science Cafés for Ideas Exchange
Esther Nakkazi, the founder of the Health Journalists Network in Uganda (HEJNU), uses the media science cafés as a platform to link HIV scientists, advocates and journalists in an ongoing conversation about complex issues like the HIV vaccine. This way, journalists would know how to evaluate new data. Is it a breakthrough or just more information about the process of getting to a vaccine?
In Kenya and Zambia, Daniel Aghan and Lorraine Mwanga lead similar get-togethers, through The Media for Environment, Science, Health and Agriculture (MESHA) and Zambia Institute of Mass Communication (ZAMCOM) respectively. Aghan and Mwanga agree that journalists should network and follow the long-winding research, then help their readers, listeners and viewers make sense of it.
Find out: What is the HIV vaccine story now?
The HIV vaccine is that “special child” Ntando told the journalists about. It’s a bumpy road, but we’re heading in the right direction. We’re baking cakes until they don’t flop.
Estimates are that in some parts of the world, an effective HIV vaccine could reduce new annual HIV infections by nearly half in its first 10 years. Important vaccine results are due in 2020 and 2021 and editors will rightly have their sights on those stories. Journalists must know what to make of the data and tell their readers and listeners if there is a breakthrough or not. If yes, it will be an important story to get right.
Ida Jooste is Internews’ Global Health Advisor.
(Banner photo courtesy of AIDS 2018 Media Team)

When Mackrine Rumanyika, Executive Director of a health advocacy organization focused on Tanzania’s Maasai community, was invited to Dar es Salaam to a gender-themed roundtable discussion by Internews in Tanzania, little did she know that her presentation would be a spark that would light a big fire.
In January, Internews organized a roundtable event for media and to discuss gender issues, and in particular, ways in which the media and civil society could collaborate to address female genital mutilation (FGM) and other forms of gender-based violence.
Nanginyi Nalepo and Elizabeth Jama Laizer, in traditional Maasai dress, speak with journalist Theodatus Muchunguzi, of Nipashe newspaper, at right, and Shifa Hassan from the Media Council of Tanzania, at the Internews roundtable in Dar es Salaam.Mackrine gave a powerful presentation on the state of the health of Maasai women, citing FGM to be a leading cause of gender-based violence in the community, inflicting serious physical and psychological suffering.
“FGM renders a woman disabled physically and mentally: she can’t enjoy sex anymore, during delivery she may develop serious complications which can lead to death,” stated Mackarine during the roundtable.
Elizabeth Jama Laizer, who escaped FGM as a child, told roundtable participants how her father chased her and her mother away after she refused to undergo FGM, which in the Maasai community still remains an important rite of passage before marriage.
Elizabeth was forced to live in hiding to finish her education. Her father would not give up and tried to trap her and have her undergo FGM and marry an older man from whom he had already taken a number of cows as dowry. Today, Elizabeth is a certified kindergarten teacher works with Mackrine’s organization, Health Integrated Multi Sectoral Services (HIMS), as a peer educator.
“I will choose a man to marry and not the one forced on me by my father,” Elizabeth stated.
Besides senior journalists and editors from different media outlets, the roundtable brought together CSO and donor representatives as well as more than 70 members of the Maasai community living in the city.
Displaying the tools recovered during HIMS’ campaign to stop FGM in Tanzania, Mackrine touted success in convincing more than 160 female practitioners of FGM to abandon the practice, in exchange for sheep – a practical and effective swap that helps them to earn a different living and to upgrade their social status in a culture where men dominate livestock ownership. Some of these former FGM practitioners have now joined her organization’s campaign, after becoming aware of the adverse effects of FGM on the health of a woman.
“After the education from HIMS and seeing the blood of those who have been cut, I decided to stop the practice,” said Nanginyi Nalepo, a former assistant circumciser, during the roundtable.
Participants at the roundtable agreed that although Tanzanian media has covered the issue of FGM for a long time, more media intervention is needed. The roundtable therefore was an opportunity to create further awareness and social change around the issue.
According to Mackrine, the roundtable achieved just that: before, HIMS and its work was hardly known outside Arusha. “Following the coverage of the roundtable meeting, more than ten media outlets and other partner organizations have approached me for interviews and collaborations,” stated Mackrine.
Saruni Muriatoi Laiza, a community leader of the Maasai community in Dar es Salaam, said most of the members of his community who participated in the Internews event would like HIMS to conduct more awareness campaigns in their villages.
“Internews has created new opportunities for us to scale up our work. The demand to offer awareness training is higher than our limited resources can cope with,” Mackrine stated, adding that following the roundtable, HIMS had been approached by World Vision Tanzania and Embudeo, a Maasai community in Ngorongoro, with requests to organize FGM awareness campaigns.
On International Women’s Day on March 8, this year, HIMS was among 30 organizations invited by a Maasai non-governmental organization, SIDAI, to present a paper on the health effects of FGM to a group of 70 Maasai women. She attributes this to the publicity she got after facilitating the Internews roundtable.
At the close of the roundtable focused on gender-based violence and women’s health, members of the Maasai community in attendance performed a traditional dance.
. . .
Internews’ five-year, USAID-funded ‘Boresha Habari’ project works to strengthen the professionalism and skills of media outlets and civil society organizations (CSOs) across Tanzania and to provide opportunities for Tanzanian media to engage and collaborate with CSOs. Internews’ project also aims to support Tanzanian media and CSOs to create greater awareness of women and youth issues locally, nationally and internationally. Story by Alakok Mayombo, Senior Journalism Trainer and Wenceslaus Mushi, Media and Communications Director, Internews in Tanzania.
(Banner photo: Internews ‘Boresha Habari’ project brings together media and the Maasai in Dar es Salaam. Credit Victoria Rowan/Internews)

Journalists in Kenya are often exposed to traumatic events, including the coverage of acute human anguish.
“I have a video on my phone of police officers burning a suspected cattle rustler in Laikipia. There are videos and images which if I were to show you, you would not believe this is Kenya,” remarked a journalist during a recent roundtable in Nairobi, held by Internews to understand and share how trauma affects journalists’ mental health.
In addition to bearing witness to human suffering, journalists sometimes find themselves in situations where their lives are in imminent danger.
Human Rights Watch and Article 19, in their report titled “‘Not Worth The Risk’: Threats To Free Expression Ahead of Kenya’s 2017 Elections,” highlighted 17 incidents in which 23 journalists and bloggers were physically assaulted between 2013 and 2017 by government officials, police, county governors, and other government officials.
Despite receiving formal complaints from journalists, police have rarely investigated such attacks or threats. According to the report, there is no evidence of any security officer or public official being held accountable for threatening, intimidating, or physically attacking a member of the media in Kenya since President Uhuru Kenyatta took office in 2013.
This year, Kenyan media have reported multiple attacks on journalists. Some incidents were instigated by local communities who accused journalists of broadcasting or printing stories that were purportedly fake or inaccurate, as was in the case in Turkana where community members attacked journalists on two separate occasions.
During the psycho-social roundtable event, Kenyan journalists recounted such traumatic experiences, including the harassment they experienced while covering Kenya’s 2017 general and repeat Presidential elections in different parts of the country. Some of the journalists noted that they were attacked by security personnel and by supporters of political candidates, on the assumption that the journalists were aligned to their opponents.
One journalist, for instance, said he declined showing his identity card and press card when asked to do so by opposition protesters in Nairobi for fear that, on the basis of his name, ethnicity and presumed political leanings, he would be beaten and his camera destroyed. He felt his only option was to leave the area as soon as he saw an opportunity to do so.
In another incident streamed live on television, Citizen TV journalist Francis Gachuri was roughed up by supporters of opposition coalition NASA when he went to cover a press conference. In a show of support and protest, journalists covering the event staged a walk out and the NASA Communications Director Philip Etale ultimately apologized to the media.
A first step: seeking help
The February roundtable was organized as a follow-up to a forum on journalists’ safety held by Internews in Nairobi in January 2018, in which KTN journalist Duncan Khaemba narrated his near-death experiences while covering the 2017 elections, where he was attacked and arrested.
Speaking to the journalists, Annabel Iraki, the Head of Human Resources at Mediamax Limited, one of the leading media houses in the country, challenged journalists not to suppress traumatic experiences. “Remember you are a human being first before being a journalist,” she emphasized.
Dinal Kituyi advised journalists on seeking help for emotional trauma.Dinah Kituyi, a psychologist with the nonprofit IREX, affirmed that as a result of attacks and challenging experiences faced by journalists, their quality of work and inter-personal relationships are affected. Yet there are little efforts to provide emotional and psychological support to journalists in media houses. “Mental health issues are as important as physical security,” she stated.
Ms. Kituyi took the journalists through the way the brain functions, to explain the impact of traumatic experiences on mental health. She advised that seeking psychological help, including sharing experiences with colleagues, should underpin their day-to-day work. Failure to do so would lead to journalists feeling emotionally drained by the issues they cover, negatively affecting both their work and life outside of work.
Ms. Kituyi advocated for journalists to employ strategies to better protect themselves and reduce risk of exposure and physical harm, including digital and physical security protection trainings. She urged them to install apps like cameraV, a mobile application that conceals photos and restricts access to images, to protect against anyone who wants to seize a journalist’s phones to delete or tamper with photos.
Asked whether they had ever attended such an event before, only one journalist out of 38 raised his hand, underscoring the need for more mental health forums for journalists across the country. “We leave here with rich knowledge on how we can better protect ourselves, even without professional counseling services,” said one participant, alluding to the importance of engaging in group support with colleagues in the newsroom and sharing traumatic reporting experiences.
As a result of this roundtable event, journalists working with Mediamax made a commitment to take advantage of the counseling services that the organization provides to staff through a professional counseling company in Nairobi, while other participants committed to speaking to their editors and managers to get their buy-in on the need for psycho-social support services in newsrooms.
. . .
By Shitemi Khamadi, Roundtables and Forums Coordinator, and Wakio Mbogho, Journalism Trainer with Internews in Kenya. Internews’ work on journalist security and psychosocial health is supported by USAID and Freedom House.
(Banner photo: Standard newspaper’s journalist Kiundu Waweru on assignment in Nairobi’s Mathare slums in 2012. He has since joined Internews as a health media trainer, Health Voices Amplified project. Credit: Kate Holt)

This World Aids Day, in this video, three top AIDS scientists: Dr. John Mascola, Director of the Vaccine Research Center at the National Institute of Allergy and Infectious Diseases at NIH; Françoise Barré Sinoussi, who discovered HIV at Institut Pasteur in France; and Anthony Fauci, Director of the National Institute of Allergy and Infectious Diseases at NIH, appeal to journalists to do what they can to turn the epidemic around - through stories that explain why the science matters and by using metaphors they ordinary people can relate to.
In 2000, just 685 000 people living with HIV received antiretroviral therapy. Now, nearly 21 million people living with HIV are on treatment, as announced by UNAIDS. People with HIV can expect to have a normal lifespan if they are on treatment. But stigma still keeps many millions of people from testing regularly. In many parts of the world, health policy has to reform so that people can access Pre-Exposure Prophylaxis or PrEP, the once-a-day prevention pill for those at high risk of HIV infection. "PrEP works" is the simple message: now, put it to work!
This year’s World Aids Day theme is The Right to Health. But those most affected by HIV are often the most marginalized in society; they are also the most frequently denied their right to health. Internews regards trusted health information as a basic right and a key service in its own right. In many parts of the world, good news stories from science are not known – in part, because the science is complex. That is why our Coalition to Accelerate and Support Prevention Research (CASPR) project with AVAC works with journalists to translate the science.

Pah! Pah! Pah! The gunshots roared.
“Wee badilisha magazine! Change the magazine!” ordered the cop.
Pah! Pah! Pah! The police-issue G3 rifles spat in hair-splitting continuity. In the mayhem, the cop tells Ken Simiyu to not fear, to just keep on the ground, to stay still.
Ken Simiyu of Radio Akicha reported on peace talks between warring West Pokot and Turkana communities. During the talks in January 2016, in Lobei Kataruk, Turkana County where most people are armed, the participants were asked to lay their guns down as a sign of goodwill.Simiyu, a journalist with Akicha radio, which broadcasts in Turkana, the marginalized Kenyan county nestled 700km north of the capital Nairobi, lay on the ground next to police inspector Kipkorir Koech, whose index finger never left the trigger.
Something hit Simiyu, and he felt a burning sensation in his hands and face. He thought he was hit by a bandit’s bullet – they are sharpshooters and masters of camouflage.
“No worries, those are just cartridges,” Simiyu remembers Koech reassuring him.
Though this was not his first time caught in a shoot-out between police and the cattle rustlers and highway robbers who roam the dry and expansive county, Simiyu was very afraid. Nevertheless, he recorded audio of the shoot-out and a hazy video, a memento of a day in the life of a journalist in Turkana.
Simiyu had accompanied police from Lodwar, the administrative center of Turkana, as they escorted a truck loaded with goods to Kainuk, a place that is dangerous even by Turkana standards. The bandits had attacked travellers the night before and Simiyu was following the story when they too were attacked.
“In May 2015, I was caught in the melee in nearly the same spot. I had accompanied Turkana leaders. They were on a mission to quell disquiet between the Pokot and Turkana.”
The Pokot and the Turkana are neighbouring communities who have for ages been embroiled in armed raids on livestock. Kainuk strides the border of West Pokot and Turkana counties, and Simiyu says youths from West Pokot had blocked the road for close to a week. This road is a lifeline for both counties. Trucks which supply the dry region with food had been held up, and the food was rotting.
The leaders were hoping to peacefully negotiate. Instead they were met with unforgiving gunfire, but luckily this time no one was hurt.
Ken Akicha of Radio Akicha was accompanying the Catholic Nomadic Mission to Oropoi village at the border of Kenya and Uganda, Turkana County on May 2016 for a story on the devastating effects of tsetse fly when their truck got stuck in mud. A Catholic priest named Oropoi “the land of sorrows” due to its huge problems with children’s health.Reporting from a conflict zone
Tall, dark and thin like a rail, Simiyu is a self-motivated journalist, one of the few who work from Turkana. We met him in June during an Internews training of the Health Voices Amplified (HVA) journalism program on maternal and newborn health. Health journalism, or any other kind of journalism related to development, is non-existent here.
But there are stories to be told. Venturing out of Lodwar town, the terrain suddenly changes a few minutes out. Women, traditionally dressed, their necks overwhelmed by coloured beads, sit under tree shades next to their manyattas, traditional mud and dung-walled structures. The men are sprawled in shades, their heads resting on wooden ‘pillows,’ ekcholong, while children play, mostly naked.
Other children have distended tummies, rickety feet, red hair. At a media roundtable on nutrition organised by the Internews HVA project, Cynthia Lokidor, the Deputy County Nutrition Coordinator, said nearly one in four children under the age of five suffer the effects of malnutrition, and one in four has stunted growth. This rate of affliction, exacerbated by prolonged droughts, surpasses the World Health Organization’s emergency threshold of Global Acute Malnutrition.
If Turkana is one of the worst places to be a journalist, then it is a nightmare to be a mother here. It has a Maternal Mortality Ratio of 1594 deaths out of 100,000 births, much higher than the national average at 495 per 100,000 and almost at par with war-torn Somalia and Afghanistan.
Why is it so difficult to shine a light on these health crises? Apart from insecurity, there are myriad other challenges, including the terrain. Driving a short distance from Lodwar town, suddenly the tarmac road becomes an unpaved road, then a dusty path as you hit what resembles a desert. During the dry season, cars get stuck in sand. When it rains, it pours. Rivers suddenly sprout where only dust existed.
Reporters would need to hire a four-wheel drive and police escort for $150 daily. Most journalists here are freelancers and contributors earning less than $150 a month. The stories from the interior only see the light of day when a journalist from Nairobi or from global media dares to travel here. The local reporters call them "helicopter journalists."
Says Peter Warutumo of NTV, “They jet in and out, doing stories in a hurry; oblivious that most of these stories are untouchable [locally].”
Hostility from politicians and other interest groups threaten local reporters. As a motorbike taxi rider recently told this writer, huku hamna sheria – this is a lawless jungle – and there can be consequences for angering the wrong person, as Joan Letting found out.
Letting, a young and talented Kenyan journalist, recently reported a story for Kenya’s The Standard newspaper, the country’s second-largest daily publication, on oil and gas. Kenya struck black gold in 2011 in Turkana. Naturally the locals want to benefit from the find, and politicians have moved in to curry mileage with their followers. Letting revealed that two opposing leaders differ on the percentage of the spoils which the Turkana County should get from the sale of oil.
“One of the camps was not happy. Someone told me I had been discussed adversely in a high-level meeting. I was told to ship out, that I was marked.”
Letting left. She now reports from Eldoret, 400 kilometres away. If there is an important event to be covered in Turkana, she travels at night, hastily gathers the story and then retreats.
Like Simiyu, most of the journalists in Turkana come originally from other counties. Pauline Muthoni, a radio host with local radio station Ekeyekon is from Lamu, a coastal county almost 1000km from Turkana. She attended college in Eldoret and came here as an intern.
“You know in Kenya, getting an internship has become as hard as getting a job. But because no one dares come here, there are opportunities.” She bussed in with several other adventurous college mates two years ago. The others did not last.
A few soldier on, like Simiyu, now trained, increasingly telling investigative stories about health issues. This is his eighth year here, and with a young family and a commitment to telling stories that need to be told, he doesn’t plan to leave.
. . .
Kiundu Waweru is a health media trainer with Internews in Kenya. Internews’ current health reporting work in Kenya, Health Voices Amplified, is supported by the UK’s Department for International Development (DFID). Ken Simiyu is one of the journalists trained under the project on maternal and newborn health in Turkana and he has been filing in-depth radio programs on the same with support from Internews. The project also has trained and mentors journalists in Bungoma County, besides building the capacity of DFID communication officers and county health officials in Turkana, Nairobi and Bungoma.
(Banner photo: Ken Simiyu of Radio Akicha, left with camera, is joined by other journalists working out of Turkana, Sammy Lutta of Nation, front, and Emmanuel Cheboit of Citizen TV. They were covering the Red Cross as it donated food to drought stricken Kapedo residents on January 1, 2017. )

“Prior to my training with Internews, I had never worked with data because, quite honestly, I didn’t know how,” recounts Ovidio Sanic Larios, a radio journalist based in Guatemala. Ovidio has documented how residents of the Guatemalan border towns of Jutiapa, Jalapa, and his hometown of Chiquimula, must travel to El Salvador to receive medical attention. “To visit hospitals on both sides of the border was quite the experience. I never expected to see first-hand such an inconsistency in medical treatment.”
“My initial hypothesis was that the public health crisis in Guatemala and Honduras had increased the number of patients who travel to El Salvador to receive medical attention. After witnessing the vast number of Guatemalans receiving care in Salvadoran hospitals, I realized that I had enough cases to allow for an investigation devoted solely to my home country,” said Ovidio, with some relief.
With the help of his tutors Ana Carolina Alpírez and Sofia Menchú, Ovidio was able to expose some startling numbers. In the first quarter of 2017, 560 patients from Guatemala registered at the Salvadoran hospitals of San Juan de Dios Regional Hospital in Santa Ana and the Dr. Arturo Morales National General Hospital in Metapán to receive medical care.
Radio journalist Ovidio Sanic Larios investigated the public health crisis in Guatemala. Credit Internews“My tutors checked in with me every week. They encouraged me through the drawn-out process of requesting previously unreleased information from the Salvadoran government,” acknowledged Ovidio with gratitude.
After four months of repetitively requesting information about the number of foreigners receiving medical assistance, the Salvadoran Health Ministry’s Public Information Office (Spanish: Oficina de Información y Respuesta del Ministerio de Salud de El Salvador) delivered some scanned copies of their records.
Once Ovidio finally received the data he required for his investigation, he encountered one immense challenge.
“When I left my job, I was devoid of the tools I required to analyze my data. It was not easy, but it was essential for me to be as forthright and impartial as possible during the entire investigation process; this was the biggest lesson I learned from Internews’ trainers. My goal was to allow everyone to verify my findings.”
Parts of Ovidio’s radio reports can be found in two posts on Facebook:
Guatemaltecos Encuentran Salud Gratis en El Salvador!
Relatos de Pacientes Guatemaltecos Atendidos en El Salvador
“I was so happy when I read the reactions to my work. It was wonderful to see people validate my findings on social media. I truly feel like this investigation ignited a passionate relationship with data journalism,” said Ovidio, who continues to work with Internews on an investigation into the effects of climate change in Guatemala.
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Internews’ work with Ovidio is part of the Promoting Journalism and Freedom of Expression program to support journalists and media outlets to develop and increase investigative and data journalism skills, with support from United States Agency for International Development.

“Having the opportunity to tell stories from these rural communities is like telling our own stories. We are inspired by the relationship with people we know.” – Alpha Senkpeni, LACSA Radio, Grand Bassa in Liberia.
Ebola is over, but the stories that linger in Liberia will be local journalists’ task to tell for a long time to come, says Alpha Senkpeni. Spending a day with Alpha and other Liberian journalists is a refreshing reminder of how community radio works: by listening and then relaying and listening again. And the questions he asks his audience all the time are: What do you want? What bothers you? What do you feel? What makes you laugh?
Henry Gboluma of Kpo Radio in Gbarpolu, Alpha Senkpeni of LACSA Radio in Grand Bassa and Eric Opa Doue of ECHO Radio in River Cess County represent just three of the Local Voices network of community journalists working in Liberia’s fifteen counties. The group was formed in 2015 by rural journalists who participated in Internews’ Information Saves Lives Ebola training and mentoring program. During the training, participants realized that they were in the unique position to tell stories about issues in rural Liberia to local as well as national and international audiences. Post Ebola, they have continued to be ears and eyes for people in all corners of the country.
They’ve come to Monrovia for the day, but their phones ring non-stop with complaints and bites of information from home, where the stories are. Henry gets a tip-off about problems with immunization and makes a mental note to run a talk show about it. Eric hears about how health workers have to stand in water to treat patients – the roof leaks everywhere. Local Voices journalists were all enrolled in the second Information Saves Lives program Internews offered, which worked with journalists from community and national media to report on the long-term impact of Ebola and on the fact that many other pathogens presented a low-grade but lingering health emergency. Health indicators in Liberia show unacceptable rates of deaths from treatable and preventable diseases, a high maternal mortality rate and seriously under-resourced public sector services. This second Internews program has ended, but the Local Voices group has taken the baton and continue to lift the voices from rural Liberia.
Local Voices is a prime example of the desired outcome of development aid: that locally-grown organizations should emerge and thrive. The journalists are from different media houses but united in their vision that the people of Liberia (not just the powerful people) should be heard about what matters most to them. Ahead of the Liberian elections, Local Voices received a grant from the Internews Liberian Media Development Project for issues-based coverage of the election.
“We keep getting stronger,” says Alpha. “As individuals, our stories are getting better, and as a group, we are a network of reporters who have strong emotional attachment to rural Liberia.”
Alpha, for example is on a year-long study and media attachment tour in China. Emmanuel Degleh, whose article on a collapsed road showed that people could not get to medical care, got the attention of the public and government officials and that got the road fixed. He has also won a fellowship with Thomson Reuters Foundation as a result of his health reporting.
Systems, organizations, individuals
At a critical time of the Ebola crisis in Liberia, there was panic and fear, rumor and distortion as people were trying to make sense of disease. The way to make impact was to identify information platforms that could swiftly allay fears and provide accurate information about Ebola. Information Saves Lives, supported by USAID’s Health Community Capacity Collaborative (HC3), started with building the skills of individual journalists to understand the science of Ebola and correct rumors on the airwaves. In time, radio stations would become an integral part of the health communications response system: health providers, community mobilizers and journalists informing Liberians about Ebola developments and engaging them to collect and correct rumors.
When Ebola ended, health emergency respondents at all levels did stocktaking. In his book Ebola, Paul Richards writes of his observations in Sierra Leone: “The international community’s alarmed response failed to take account of local expertise and common sense,” which Richards calls “people science.” Reflecting on how the humanitarian community would do it better next time, Parker Williams, who was with the Ebola Response Team of the International Committee of the Red Cross has stated that COMMUNITY ENGAGEMENT has to be written in capital letters.
The Information Saves Lives project had recognized how community engagement and “people science” happens on community radio.
During a visit to Echo Radio in River Cess County, Eric Opa Doue explains why it works to talk to communities via journalists and talk show hosts on trusted radio stations – whatever the issue is that needs to be urgently talked about.
Eric Opa Doue of Echo Radio relays texts back to the audienceWhen Eric’s show is on, he is all arms and hands and ears, as he fields calls and reads texts from listeners to experts and lets the experts speak back to his community. He treats callers as trusted experts on their own needs, wants, and concerns. This community relationship did not start nor end with Ebola.
Eric explains that his station is a bridge of information in and out of the community on all topics. “Because the journalist can serve as police, can serve as doctor, as the immigration official ... they can serve as just anything you think of.” When the health crisis was the topic, community members knew he did not have an agenda, other than to serve them with information and a way to talk to one another.
Parker Williams reminds us that in 1948 when the World Health Organization’s constitution was written, it was clearly stated that the participation of an informed public is essential to its public health. “Seventy years later, we are still struggling to see how that could be done.”
Health for the long haul
Health is a complex science. Attitudes about health, particularly when something is new and frightening, are even more complex. Months after Liberia reached the end of active virus transmission, news came of the death of Salome Karwah, a woman who survived Ebola and was named a TIME Person of the Year for her dedication to fighting the disease. She died of childbirth complications after she was refused help from hospital staff, who feared she had not survived Ebola after all.
Henry Gboluma of Kpo Radio told me that Ebola-related stigma was something to which he and his colleagues across the country would have to keep going back. Ebola is dead, but stigma is not, he said. Internews’ training included guidance on how the language journalists use and the way they educate and engage the public can play a significant role in reducing stigma and shaping social norms.
“Many of our members either grew up or worked in these communities for years. They know the challenges in these communities,” Alpha tells me. “Our group is cognizant that the media can play a vital role in solving these challenges - be it health and stigma, education or infrastructure.”
. . .
Ida Jooste is Global Health Advisor for Internews.
Information saves Lives I and II were projects run in partnership with The Health Communication Capacity Collaborative (HC3), funded by USAID. HC3’s aim has been to strengthen capacity in developing countries to implement state-of-the-art social and behavior change communication (SBCC) programs – which are ideally networked in a social and behavior change ecosystem. To make the social and behavior change ecosystem better, HC3 designs capacity strengthening of individuals, organizations and systems.
(Banner photo: Alpha Senkpeni, Henry Gboluma and Eric Opa Doue, Local Voices)

Asela Kuruluwansha is used to seeing horrific footage on nightly newscasts aired over Sri Lankan TV channels. He is often left repulsed and makes sure that his young children are prevented from watching them. A difficult task given that the news in the local languages sometimes follows right after the cartoons finish.
But beyond shielding his kids, Asela, a senior journalist with the state-owned Dinamina, one of Sri Lanka’s largest circulation Sinhala daily newspapers, had not taken any other action.
Recently though he has been moved to take action over the reportage of suicide in local media. “It is not right, just because there is footage or intimate details, we should not go to press, there should be moral judgment over the news judgment,” Asela told Internews senior journalism trainer Amantha Perera last week.
Asela had been dismayed by the airing of graphic footage of a young man committing suicide by leaping onto an incoming truck on two Sri Lankan channels, Hiru and state owned Rupavahini on the evening of September 12.
Soon after he saw the footage he called Amantha and together they informed officials of the Information Department of the footage. The initial reaction was that the offending footage was removed from Hiru’s late night broadcast.
The next morning, to their dismay, Asela and Amantha found that the clip was not only available on the respective Facebook and Twitter feeds of the channels but was being promoted. In one instance, red circles were drawn on the image to clearly mark the point of impact – between the head and the rear wheel.
Again requests were made to relevant officials and the clips were removed.
Asela’s thinking on the issue did not evolve out of the blue – there was a process behind it. Asela has been a one of several dozen Sri Lankan journalists mentored under the Internews One Sri Lanka Programme and Fellowships.
The fellowships aim to encourage journalists to report on complex subjects like race, religion, post war reconstruction and reconciliation, human rights and even suicide under the guidance of a mentor with international and local experience. They also get the chance to attend workshops where such issues are discussed candidly.
Asela was part of one such workshop where the subject was reporting on suicide. A few weeks before that workshop, Asela had refused to write a story on the suicide of a young woman. The story had all the details of Bollywood melodrama – a young, beautiful woman commits suicide by leaping on to an incoming train after being ditched by her lover. Asela had more intimate details than others. But he refused to write the story despite the insistence of his superiors.
He did so because he felt, the suicide had no mass news appeal and to publicize the intimate details would be nothing less than violation of privacy.
“In Sri Lanka, media capacity building has become a lopsided endeavor,” Amantha noted. “What is carried out more often than not is decided by not what is needed here but what is deemed as needed. Much of it without any deep analysis of local circumstances.”
He continued, “So we have had countless programs on investigative journalism or on data journalism among others. These are needed, but what is lacking in Sri Lankan media is hands-on training on news judgment and reporting. Once that urgent need is met, then we can branch out to other issues. But if we do not reinforce the awareness on fundamentals of journalism, whatever we build on top of them will be standing on shaky ground.”
The Internews fellowships have given journalists the chance, not only to develop key journalism skills like new reporting, sourcing and use of data, and an emphasis on long term engagement, it has given trainers and strategists the chance to enter into a dialogue with the participants. That dialogue begins at workshops but fortunately does not end there.
It is such a dialogue that Amantha had with Asela on the reporting suicide. And it has had a big impact, not only on one of the senior regional journalists working in the vernacular but also within the community.
It is a dialogue that needs to continue, widen and diversify. And this is best accomplished by fostering long term engagement between working journalists and trainers.
. . .
Shifan Ahmed is Program Manager for Internews in Sri Lanka.
(Banner photo: Pettah, one of the oldest districts in Colombo, is a swirling center of commercial activity. Credit: Dan Lundberg/CC)

Liberians went to the polls on 10 October 2017 to elect the President and House of Representatives. In the run-up to elections everywhere in the world, party politics, campaign trails and – more often than not - character assassination drive the news agenda. Health stories don’t make the front page. In fact, health stories hardly make the front page, ever. But a group of Liberian journalists have changed that.
“Especially during election times, the thinking used to be that only politics sells. But there’s a new kind of story we are looking for, and it is about what is done for the health of people? So it combines politics and health,” says Alpha Daffae Senkpeni, Front Page Africa editor.
Alpha is also in the leadership of Local Voices, a network of community radio journalists working in Liberia’s 15 counties.
Journalist Alpha Senkpeni (R) surveys health information needs.Alpha was among the participants of two Internews health media projects in Liberia. The first, Information Saves Lives was introduced in response to the Ebola crisis.
The Ebola crisis is over. But Ebola had opened the window to insights on weaknesses in the Liberian health system. David Sanders, who is affiliated with the People's Health Movement, a global network advocating for health equity, writes in The Conversation that the explosive Ebola and Zika outbreaks are an indication not in the pathology of disease, but in the pathology of society. “Unless the global public health community develops better health systems that provide for the poor, such viruses will continue to spread and have severe effects,” he writes.
I had the opportunity to interview Anthony Fauci on what he thought the world had learned from Ebola. Fauci is the head of the National Institutes of Health’s Institute of Allergy and Infectious Diseases. An immunologist, he mentions health systems before hard science.
“The thing that Ebola has told us very clearly is that avoiding things like this in the future really rest on building up a reasonable health care infrastructure, because one of the predominant reasons why we had the explosion - truly an explosion - of cases in the three countries of Liberia, Sierra Leone and Guinea, was the fact that the infrastructure there was marginal at best.”
Ebola put a spotlight on infrastructure weaknesses in Liberia, including flaws in the flow of information, and brought to the fore other low-level health emergencies, among them maternal and child health, measles and tuberculosis. With the riot of disease and death behind us, the international community and Liberian authorities said it would use lessons from Ebola and be proactive about building health infrastructure.
For Internews, accurate, trusted and compelling health information is a vital part of health infrastructure. Well-informed health journalists, through their stories, are watchdogs of health services. To help journalists apply the lessons learnt from Ebola, Internews launched Information Saves Lives II.
“If we had been prepared as health reporters before, the way in which we reported the crisis at the beginning would have been different,” said Antoinette Sendolo, a journalist with The Inquirer.
Information Saves Lives II was the first dedicated health journalism fellowship for Liberian journalists. Antoinette was among 24 Liberian media fellows enrolled in the program of intensive training sessions in Monrovia. They interacted with and learned from Ministry of Health clinicians, patients, and international experts on topics such as maternal and reproductive health, mental health, health systems strengthening, infectious diseases and chronic diseases.
“If we have another outbreak that is not Ebola, we will be in a better position to report. The essence of journalism is not just reporting; it’s about making impact,” says Antoinette.
The politics of health
At one of the training forums, the group discussed how to connect health to politics. In the run-up to the Liberian election, health stories have in fact made the front pages. A community radio reporter for Radio Gbarnga, Moses Bailey, reported on Phebe Maternal Waiting Home in Bong County, where pregnant women wait for hours to be seen, often suffering from food scarcity and hunger. The story moved readers to donate food and money for supplies. In another story, Moses showed neglect at mental health facilities. The journalism fellows came to realize that health stories are not just about disease, science, or symptoms – they can also be about the services that government does or does not deliver.
Beds at Phebe Maternal Waiting HomeA Front Page Africa story outlined how a desire for better roads and health care will affect election results. A voter says the only way to voice her concern about bad roads and lack of health care is at the ballot box. Another story looks at the readiness of health centers to deal with a future Ebola outbreak. There’s a report about the challenges at the Bong Mines Hospital in Bong County: hardly any drugs, no electricity and no pay for staff. And a story about a ramshackle clinic in Gbloseo Town read “As Election Day draws near, healthcare will be one of the issues on the minds of voters.”
Empty containers on the shelves of the dispensary at Gbloseo. Photo: Eric Opa DoueThe journalism fellows are thrilled about their success in putting health on the news agenda. Because of the unique stories they are finding, many have found freelancing opportunities, opening their efforts to wider audiences. By the end of the Information Saves Lives program, seven front page articles on health issues had been published.
“I thought of writing an OpEd about the lessons that have come from Ebola, even though it has been tragic,” says Alpha. “We’ve learned how to be specialists in health journalism. And that a specialist is not just someone who reports on disease. We report to prevent disease.”
. . .
Information saves Lives I and II were projects run in partnership with The Health Communication Capacity Collaborative (HC3), funded by USAID.
(Banner photo: A community radio story about pregnant women waiting for health care moved readers to donate food.)

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